Objective To summary the pathological classification， clinical manifestations， diagnosis， and treatments of gastrointestinal neuroendocrine tumors （GE-NETs）. Methods Domestic and international literatures were collected to summary the status of clinical researches and treatments of GE-NETs. Results GE-NETs derived from enterochromaffin cells throughout the gut which had the function of amine precursor uptake decarboxylase （APUD）. These tumors secreted discrete bioactive substances and produced characteristic immunohistochemical patterns， making patients to manifest endocrine syndrome. But there were no unified standards on the diagnosis， grade， TNM classification， and prognosis of GE-NETs. Early diagnosis rate of GE-NETs was low， and most of tumors were asymptomatic and detected at late stage， with a tendency to metastasize to the liver. Imaging examation was important in early diagnosis of GE-NETs. Surgery was the traditional first-line therapy and the only possible curative approach. Somatostatin analogues， such as long-term-release （LAR） octreotide， could relieve the hormonal symptoms， slow down the tumor growth， and had shown synergistic antiproliferative activity in combination with biological agent everolimus. Conclusions The lack of standardized classification and an incomplete understanding of this disease are some of the impediments to the progress of treatment. Individualized comprehensive therapy is the aim of the future treatment.
【摘要】 目的 评价以问题为基础式学习与病例讨论式学习在“临床风险筛查”培训教学过程中的应用效果。 方法 2010年6月-2011年7月，联合应用两种教学方法对参训医学生进行培训，然后进行临床资料采集、资料整理等实践活动。最后，对学生培训效果进行总结。 结果 共培训医学生50人，并对398例患者进行营养风险筛查。45人（90%）参与者认为此教学方式能激发自身主动学习兴趣，40人（80%）认为通过此次培训能够使学生逐步建立科学研究的思维方式，但有20人（40%）认为短期内采用两种教学方式能够对论文写作、统计学理论和实践等方面能力的提高有促进作用。影响医学生科研能力培训效果的主要因素集中体现在学习任务量的加重、对新教学方法不适应、自学能力三方面。 结论 联合应用问题为基础式学习与病例讨论式学习教学模式，在提高医学生学习主动性、积极性、团队合作及人际沟通能力等方面有优势，但尚存部分问题需要进一步解决。【Abstract】 Objective To explore the effectiveness of problem-based learning (PBL) and case-based study (CBS) in clinical nutritional risk screening training program. Methods All the students were trained by the combination methods of PBL and CBS. Clinical assessment, data collection and the collection of samples were conducted by the students. Finally, the impact of the new teaching strategy was assessed. Results From June 2010 to July 2011, there were a total of 50 students who attended the training program from various departments, and 398 patients were screened for nutritional risk. Forty-five students (90%) thought that this teaching method could inspire their interest in study; 40 students (80%) thought that this teaching method could help them establish a scientific way of thinking. Students who thought this teaching methodology could contribute to their enhancement of writing and statistical skills accounted for only 40 percent of the total enrollment. “High learning burden”, “difficulty in adapting to the new teaching methods” and “the ability of self-study” were the main factors which affected the motivation of students. Conclusions Combined applications of PBL and CBS have advantages in improving students′ learning initiative and enthusiasm, and developing the abilities of team cooperation and interpersonal communication skills. However, there are still some issues that need to be addressed.
ObjectiveTo compare curative effect of catheter drainage following ultrasound-guided vacuum-assisted rotary excision and traditional excision in treatment of granulomatous mastitis in abscess stage. MethodsA total of 38 patients with granulomatous mastitis in abscess phase from December 2016 to March 2017 in the Third People’s Hospital of Chengdu City and from March 2017 to October 2017 in the Sichuan Provincial Hospital for Women and Children were included as a study group, who were received the catheter drainage following ultrasound-guided vacuum-assisted rotary excision. A total of 38 similar cases from July 2015 to November 2016 in the Third People’s Hospital of Chengdu City were collected as a control group according to the 1∶1 matching principle, who were received the traditional excision. The therapeutic period, postoperative appearance of breast, and recurrence rate were compared between these two groups. ResultsCompared with the control group, the therapeutic period was significantly shorter (t=74.000, P<0.001), the postoperative appearance of breast was significantly better (χ2=7.280, P=0.007) in the study group, while the recurrence rate had no significant difference (χ2=0.559, P=0.455) between these two groups. ConclusionsCatheter drainage following ultrasound-guided vacuum-assisted rotary excision shows advantages in postoperative therapeutic period and appearance of breast and doesn’t increase relapse rate as compared with traditional surgery for patients with granulomatous mastitis in abscess stage.